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Since 2011, she's been writing and editing stories for the site. Before taking up blogging, she toiled for many years (more than we can count) producing health stories for television, including\u003cem> Dateline NBC\u003c/em> and San Francisco's CBS affiliate, KPIX-TV. She also wrote up a \u003ca title=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\">handy guide to the Affordable Care Act\u003c/a>, especially for Californians. Her work has been honored for many awards. Most recently she was a finalist for \"Best Topical Reporting\" from the Online News Association. You can follow her on Twitter: \u003ca title=\"https://twitter.com/laliferis\" href=\"https://twitter.com/laliferis\">@laliferis\u003c/a>","avatar":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g","twitter":"laliferis","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"futureofyou","roles":["subscriber"]},{"site":"stateofhealth","roles":["subscriber"]},{"site":"science","roles":["subscriber"]},{"site":"food","roles":["contributor"]}],"headData":{"title":"Lisa Aliferis | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lisaaliferis"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_248388":{"type":"posts","id":"stateofhealth_248388","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"248388","score":null,"sort":[1476474676000]},"guestAuthors":[],"slug":"breast-cancer-death-rates-are-down-but-racial-disparities-persist","title":"Breast Cancer Death Rates Are Down, But Racial Disparities Persist","publishDate":1476474676,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>Women are less likely to die of breast cancer than they were a decade ago, but not all women are benefiting from that trend.\u003c/p>\n\u003cp>White women saw more of a drop in death rates than black women — 1.9 percent a year from 2010 to 2014, compared to a 1.5 percent decrease for black women, according to a \u003ca href=\"http://www.cdc.gov/mmwr/volumes/65/wr/mm6540a1.htm?s_cid=mm6540a1_w\">report\u003c/a> published Thursday by the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>And while the death rates for women under 50 declined regardless of race, older black women are more likely to die of breast cancer than are white women.\u003c/p>\n\u003cp>That's especially troubling because 40 years ago, black women were less likely to get breast cancer. That's changed. Black women's breast cancer risk is \u003ca href=\"http://www.npr.org/sections/health-shots/2015/10/29/452650557/black-womens-breast-cancer-risk-rises-to-equal-white-womens\">now the same\u003c/a> as that of white women's, and black women are 41 percent more likely to die of the disease.\u003c/p>\n\u003cp>There can be some good reasons for the rise in the number of black women being diagnosed with breast cancer, like more women getting screening mammograms. But there are bad reasons, too.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The CDC report cites calorie-dense foods, lack of exercise and increasing rates of obesity as potential reasons.\u003c/p>\n\u003cp>And while this report found similar reductions in deaths among younger black and white women, older white women saw their death rates drop by 2 percent a year, compared to 1 percent in black women.\u003c/p>\n\u003cp>Access to care is one big reason why, according to \u003ca href=\"http://www.cancer.org/research/acsresearchers/otis-brawley-md-facp\">Otis Brawley\u003c/a>, chief medical and scientific officer for the American Cancer Society.\u003c/p>\n\u003cp>\"Forty to 50 percent of black women get less than optimal care for breast cancer, whether it's mammography or treatment,\" Brawley says.\u003c/p>\n\u003cp>They're not alone in that; poor white women are also much less likely to get adequate care, and more likely to die as a result.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We need to focus on getting good care, high-quality care to everybody,\" Brawley adds. \"We need to realize that in the United States of America in 2016 a substantial proportion of Americans with cancer get absolutely atrocious care.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Breast+Cancer+Death+Rates+Are+Down%2C+But+Racial+Disparities+Persist&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Black women are more likely to die of breast cancer than are white women, the CDC reports.","status":"publish","parent":0,"modified":1476474676,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":13,"wordCount":356},"headData":{"title":"Breast Cancer Death Rates Are Down, But Racial Disparities Persist | KQED","description":"Black women are more likely to die of breast cancer than are white women, the CDC reports.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Breast Cancer Death Rates Are Down, But Racial Disparities Persist","datePublished":"2016-10-14T19:51:16.000Z","dateModified":"2016-10-14T19:51:16.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"248388 http://ww2.kqed.org/stateofhealth/?p=248388","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/10/14/breast-cancer-death-rates-are-down-but-racial-disparities-persist/","disqusTitle":"Breast Cancer Death Rates Are Down, But Racial Disparities Persist","source":"NPR ","nprImageCredit":"Deborah Jaffe","nprByline":"Nancy Shute \u003cbr> NPR Shots","nprImageAgency":"Getty Images","nprStoryId":"497793332","nprApiLink":"http://api.npr.org/query?id=497793332&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2016/10/13/497793332/breast-cancer-death-rates-are-down-but-racial-disparities-persist?ft=nprml&f=497793332","nprRetrievedStory":"1","nprPubDate":"Thu, 13 Oct 2016 17:08:00 -0400","nprStoryDate":"Thu, 13 Oct 2016 13:57:00 -0400","nprLastModifiedDate":"Thu, 13 Oct 2016 17:08:13 -0400","path":"/stateofhealth/248388/breast-cancer-death-rates-are-down-but-racial-disparities-persist","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Women are less likely to die of breast cancer than they were a decade ago, but not all women are benefiting from that trend.\u003c/p>\n\u003cp>White women saw more of a drop in death rates than black women — 1.9 percent a year from 2010 to 2014, compared to a 1.5 percent decrease for black women, according to a \u003ca href=\"http://www.cdc.gov/mmwr/volumes/65/wr/mm6540a1.htm?s_cid=mm6540a1_w\">report\u003c/a> published Thursday by the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>And while the death rates for women under 50 declined regardless of race, older black women are more likely to die of breast cancer than are white women.\u003c/p>\n\u003cp>That's especially troubling because 40 years ago, black women were less likely to get breast cancer. That's changed. Black women's breast cancer risk is \u003ca href=\"http://www.npr.org/sections/health-shots/2015/10/29/452650557/black-womens-breast-cancer-risk-rises-to-equal-white-womens\">now the same\u003c/a> as that of white women's, and black women are 41 percent more likely to die of the disease.\u003c/p>\n\u003cp>There can be some good reasons for the rise in the number of black women being diagnosed with breast cancer, like more women getting screening mammograms. But there are bad reasons, too.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The CDC report cites calorie-dense foods, lack of exercise and increasing rates of obesity as potential reasons.\u003c/p>\n\u003cp>And while this report found similar reductions in deaths among younger black and white women, older white women saw their death rates drop by 2 percent a year, compared to 1 percent in black women.\u003c/p>\n\u003cp>Access to care is one big reason why, according to \u003ca href=\"http://www.cancer.org/research/acsresearchers/otis-brawley-md-facp\">Otis Brawley\u003c/a>, chief medical and scientific officer for the American Cancer Society.\u003c/p>\n\u003cp>\"Forty to 50 percent of black women get less than optimal care for breast cancer, whether it's mammography or treatment,\" Brawley says.\u003c/p>\n\u003cp>They're not alone in that; poor white women are also much less likely to get adequate care, and more likely to die as a result.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We need to focus on getting good care, high-quality care to everybody,\" Brawley adds. \"We need to realize that in the United States of America in 2016 a substantial proportion of Americans with cancer get absolutely atrocious care.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Breast+Cancer+Death+Rates+Are+Down%2C+But+Racial+Disparities+Persist&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/248388/breast-cancer-death-rates-are-down-but-racial-disparities-persist","authors":["byline_stateofhealth_248388"],"categories":["stateofhealth_13","stateofhealth_1"],"tags":["stateofhealth_46","stateofhealth_2519"],"featImg":"stateofhealth_248389","label":"source_stateofhealth_248388"},"stateofhealth_214392":{"type":"posts","id":"stateofhealth_214392","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"214392","score":null,"sort":[1468881238000]},"guestAuthors":[],"slug":"got-dense-breasts-that-can-depend-on-who-is-reading-the-mammogram","title":"Got Dense Breasts? That Can Depend On Who Is Reading The Mammogram","publishDate":1468881238,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>If you're a woman who gets screening mammograms, you may have received a letter telling you that your scan was clear, but that you have dense breasts, a risk factor for breast cancer. About half of U.S. states, including \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/29/californias-breast-density-notification-law-goes-into-effect/\" target=\"_blank\">California\u003c/a>, require providers to \u003ca href=\"http://www.npr.org/sections/health-shots/2016/04/26/475624010/letters-telling-women-about-breast-density-are-often-too-darn-dense\" target=\"_blank\">notify women\u003c/a> if they fall into that category.\u003c/p>\n\u003cp>But what you may not know is that gauging breast density isn't a clear-cut process. Researchers reporting in \u003cem>Annals of Internal Medicine\u003c/em> Monday found that density assessments varied widely from one radiologist to another. That means you shouldn't let one finding freak you out too much, nor should you assume something's wrong if your reported density changes from year to year.\u003c/p>\n\u003cp>\"Women and providers should keep in mind that density is a subjective measure,\" says \u003ca href=\"https://www.uvm.edu/medicine/surgery/?Page=profile.php&bioID=22952\" target=\"_blank\">Brian Sprague\u003c/a>, a cancer epidemiologist at the University of Vermont and an author of the study. And, he says, breast density is only one factor contributing to a woman's \u003ca href=\"http://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm\" target=\"_blank\">individual risk of getting breast cancer\u003c/a>.\u003c/p>\n\u003cp>About 40 percent of women between 40 and 74 years old have dense breasts — meaning they have more breast tissue (that is, ducts and glands) and connective tissue and less fatty tissue than women whose breasts aren't dense. You can't know your status by how the breasts feel; it only shows up on a mammogram.\u003c/p>\n\u003cp>Dense breasts make it harder for radiologists to detect possible abnormalities on a mammogram, and the presence of the tissue itself is an independent risk factor for breast cancer.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The researchers looked at 216,783 mammograms from more than 145,000 women, interpreted by 83 radiologists in Pennsylvania, Vermont, New Hampshire and Massachusetts. The average proportion of mammograms that fell into the \"extremely dense\" or \"heterogeneously dense\" categories was 38.7 percent. But the proportion of mammograms assigned to those two categories by individual radiologists ranged from 6.3 percent to 84.5 percent.\u003c/p>\n\u003cp>Even when adjusting for each patient's age, race and \u003ca href=\"http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm\" target=\"_blank\">body mass index\u003c/a> — since, after all, the patient population in Philadelphia isn't the same as in rural Vermont — the variation continued, the authors say.\u003c/p>\n\u003cp>And among women who had consecutive mammograms read by different radiologists, 17.2 percent got different assessments of whether they fell into the dense or nondense category.\u003c/p>\n\u003cp>The findings aren't too surprising, says \u003ca href=\"http://www.bidmc.org/Centers-and-Departments/Departments/Radiology/Data/Clinical-Faculty/Breast-Imaging/Priscilla-Slanetz.aspx\" target=\"_blank\">Dr. Priscilla Slanetz\u003c/a>, a radiologist at Beth Israel Deaconess Medical Center. \"There's agreement usually in the extremes, but a lot of variation in the middle,\" she says.\u003c/p>\n\u003cp>The guidelines for assessing density have also changed since the study was conducted, Slanetz points out, though it's not yet clear how that will affect the percentage of women assessed as having dense breasts.\u003c/p>\n\u003cp>At a policy level, the researchers say, the results mean that authors of state legislation requiring that women be notified of breast density — and in some cases, offered extra screening using other methods — need to be aware that this variation exists. If all women classified as having dense breasts are referred for an ultrasound based on that factor alone (\u003ca href=\"http://www.npr.org/sections/health-shots/2015/04/16/399946509/letters-about-dense-breasts-can-lead-to-more-questions-than-answers\" target=\"_blank\">as they are in some states\u003c/a>), that could make for a lot of unnecessary tests and false positive results without an offsetting benefit.\u003c/p>\n\u003cp>Slanetz's advice for women is to use the density report as a jumping-off point for a broader discussion about their individual breast cancer risk. Authors of a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25984843\" target=\"_blank\">large study published last year\u003c/a> said that density alone shouldn't be the only criterion for getting extra screening. Nor should women whose breasts aren't dense assume that they have a low risk of breast cancer.\u003c/p>\n\u003cp>That personal discussion with a doctor or other health care provider should cover risk factors such as personal history of breast abnormalities and family history of breast cancer, as well as density, Slanetz says.\u003c/p>\n\u003cp>She also recommends that women with dense breasts seek out digital mammography, which improves detection of cancers.\u003c/p>\n\u003cp>Ultrasound, \u003ca href=\"http://www.npr.org/sections/health-shots/2014/06/24/325216641/3-d-mammography-finds-more-tumors-but-questions-remain\" target=\"_blank\">digital breast tomosynthesis\u003c/a> and MRI have all been suggested as additional screening options for women with dense breasts. But the \u003ca href=\"http://www.npr.org/sections/health-shots/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\" target=\"_blank\">U.S. Preventive Services Task Force says\u003c/a> there's not yet enough evidence to know whether they should be used for screening.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Katherine Hobson is a freelance health and science writer based in Brooklyn, N.Y. She's on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/katherinehobson\" target=\"_blank\">\u003cem>@katherinehobson\u003c/em>\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Got+Dense+Breasts%3F+That+Can+Depend+On+Who+Is+Reading+The+Mammogram&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"A large study suggests that radiologists vary widely in their assessment of density, a risk factor for breast cancer. ","status":"publish","parent":0,"modified":1468881283,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":731},"headData":{"title":"Got Dense Breasts? That Can Depend On Who Is Reading The Mammogram | KQED","description":"A large study suggests that radiologists vary widely in their assessment of density, a risk factor for breast cancer. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Got Dense Breasts? That Can Depend On Who Is Reading The Mammogram","datePublished":"2016-07-18T22:33:58.000Z","dateModified":"2016-07-18T22:34:43.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"214392 http://ww2.kqed.org/stateofhealth/?p=214392","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/07/18/got-dense-breasts-that-can-depend-on-who-is-reading-the-mammogram/","disqusTitle":"Got Dense Breasts? That Can Depend On Who Is Reading The Mammogram","nprImageCredit":"Lester Lefkowitz","nprByline":"Katherine Hobson\u003cbr />\u003ca href=\"http://www.npr.org/sections/health-shots/\">NPR Shots\u003c/a>","nprImageAgency":"Getty Images","nprStoryId":"486473548","nprApiLink":"http://api.npr.org/query?id=486473548&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2016/07/18/486473548/got-dense-breasts-that-can-depend-on-whos-reading-the-mammogram?ft=nprml&f=486473548","nprRetrievedStory":"1","nprPubDate":"Mon, 18 Jul 2016 18:14:00 -0400","nprStoryDate":"Mon, 18 Jul 2016 17:01:00 -0400","nprLastModifiedDate":"Mon, 18 Jul 2016 18:14:47 -0400","path":"/stateofhealth/214392/got-dense-breasts-that-can-depend-on-who-is-reading-the-mammogram","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you're a woman who gets screening mammograms, you may have received a letter telling you that your scan was clear, but that you have dense breasts, a risk factor for breast cancer. About half of U.S. states, including \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/29/californias-breast-density-notification-law-goes-into-effect/\" target=\"_blank\">California\u003c/a>, require providers to \u003ca href=\"http://www.npr.org/sections/health-shots/2016/04/26/475624010/letters-telling-women-about-breast-density-are-often-too-darn-dense\" target=\"_blank\">notify women\u003c/a> if they fall into that category.\u003c/p>\n\u003cp>But what you may not know is that gauging breast density isn't a clear-cut process. Researchers reporting in \u003cem>Annals of Internal Medicine\u003c/em> Monday found that density assessments varied widely from one radiologist to another. That means you shouldn't let one finding freak you out too much, nor should you assume something's wrong if your reported density changes from year to year.\u003c/p>\n\u003cp>\"Women and providers should keep in mind that density is a subjective measure,\" says \u003ca href=\"https://www.uvm.edu/medicine/surgery/?Page=profile.php&bioID=22952\" target=\"_blank\">Brian Sprague\u003c/a>, a cancer epidemiologist at the University of Vermont and an author of the study. And, he says, breast density is only one factor contributing to a woman's \u003ca href=\"http://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm\" target=\"_blank\">individual risk of getting breast cancer\u003c/a>.\u003c/p>\n\u003cp>About 40 percent of women between 40 and 74 years old have dense breasts — meaning they have more breast tissue (that is, ducts and glands) and connective tissue and less fatty tissue than women whose breasts aren't dense. You can't know your status by how the breasts feel; it only shows up on a mammogram.\u003c/p>\n\u003cp>Dense breasts make it harder for radiologists to detect possible abnormalities on a mammogram, and the presence of the tissue itself is an independent risk factor for breast cancer.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The researchers looked at 216,783 mammograms from more than 145,000 women, interpreted by 83 radiologists in Pennsylvania, Vermont, New Hampshire and Massachusetts. The average proportion of mammograms that fell into the \"extremely dense\" or \"heterogeneously dense\" categories was 38.7 percent. But the proportion of mammograms assigned to those two categories by individual radiologists ranged from 6.3 percent to 84.5 percent.\u003c/p>\n\u003cp>Even when adjusting for each patient's age, race and \u003ca href=\"http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm\" target=\"_blank\">body mass index\u003c/a> — since, after all, the patient population in Philadelphia isn't the same as in rural Vermont — the variation continued, the authors say.\u003c/p>\n\u003cp>And among women who had consecutive mammograms read by different radiologists, 17.2 percent got different assessments of whether they fell into the dense or nondense category.\u003c/p>\n\u003cp>The findings aren't too surprising, says \u003ca href=\"http://www.bidmc.org/Centers-and-Departments/Departments/Radiology/Data/Clinical-Faculty/Breast-Imaging/Priscilla-Slanetz.aspx\" target=\"_blank\">Dr. Priscilla Slanetz\u003c/a>, a radiologist at Beth Israel Deaconess Medical Center. \"There's agreement usually in the extremes, but a lot of variation in the middle,\" she says.\u003c/p>\n\u003cp>The guidelines for assessing density have also changed since the study was conducted, Slanetz points out, though it's not yet clear how that will affect the percentage of women assessed as having dense breasts.\u003c/p>\n\u003cp>At a policy level, the researchers say, the results mean that authors of state legislation requiring that women be notified of breast density — and in some cases, offered extra screening using other methods — need to be aware that this variation exists. If all women classified as having dense breasts are referred for an ultrasound based on that factor alone (\u003ca href=\"http://www.npr.org/sections/health-shots/2015/04/16/399946509/letters-about-dense-breasts-can-lead-to-more-questions-than-answers\" target=\"_blank\">as they are in some states\u003c/a>), that could make for a lot of unnecessary tests and false positive results without an offsetting benefit.\u003c/p>\n\u003cp>Slanetz's advice for women is to use the density report as a jumping-off point for a broader discussion about their individual breast cancer risk. Authors of a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25984843\" target=\"_blank\">large study published last year\u003c/a> said that density alone shouldn't be the only criterion for getting extra screening. Nor should women whose breasts aren't dense assume that they have a low risk of breast cancer.\u003c/p>\n\u003cp>That personal discussion with a doctor or other health care provider should cover risk factors such as personal history of breast abnormalities and family history of breast cancer, as well as density, Slanetz says.\u003c/p>\n\u003cp>She also recommends that women with dense breasts seek out digital mammography, which improves detection of cancers.\u003c/p>\n\u003cp>Ultrasound, \u003ca href=\"http://www.npr.org/sections/health-shots/2014/06/24/325216641/3-d-mammography-finds-more-tumors-but-questions-remain\" target=\"_blank\">digital breast tomosynthesis\u003c/a> and MRI have all been suggested as additional screening options for women with dense breasts. But the \u003ca href=\"http://www.npr.org/sections/health-shots/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\" target=\"_blank\">U.S. Preventive Services Task Force says\u003c/a> there's not yet enough evidence to know whether they should be used for screening.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Katherine Hobson is a freelance health and science writer based in Brooklyn, N.Y. She's on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/katherinehobson\" target=\"_blank\">\u003cem>@katherinehobson\u003c/em>\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Got+Dense+Breasts%3F+That+Can+Depend+On+Who+Is+Reading+The+Mammogram&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/214392/got-dense-breasts-that-can-depend-on-who-is-reading-the-mammogram","authors":["byline_stateofhealth_214392"],"categories":["stateofhealth_13"],"tags":["stateofhealth_46","stateofhealth_2808","stateofhealth_2824","stateofhealth_397"],"featImg":"stateofhealth_214393","label":"stateofhealth"},"stateofhealth_176993":{"type":"posts","id":"stateofhealth_176993","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"176993","score":null,"sort":[1461689392000]},"guestAuthors":[],"slug":"letters-telling-women-about-breast-density-are-often-too-darn-dense","title":"Letters Telling Women About Breast Density Are Often Too Darn Dense","publishDate":1461689392,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Over the past decade, California and many states \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/29/californias-breast-density-notification-law-goes-into-effect/\" target=\"_blank\">have passed laws\u003c/a> intended to help women understand the results of their breast cancer screening mammograms if they have dense breasts. But those notifications can be downright confusing and may, in fact, cause more misunderstanding than understanding.\u003c/p>\n\u003cp>A \u003ca href=\"http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2016.1712\" target=\"_blank\">study\u003c/a> published Tuesday in \u003cem>JAMA\u003c/em>, the journal of the American Medical Association, finds the wording of some notifications so complex that only a PhD could understand them. This lack of simple, direct information could lead to greater health disparities in diagnosis and treatment of breast cancer, since having dense breasts makes it a bit more likely that a woman will have \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923218/\" target=\"_blank\">breast cancer\u003c/a>, and also that cancer could be missed on a mammogram.\u003c/p>\n\u003cp>Breast density is normal and common, but the only way a woman can find out that she has dense breasts, which have more fibrous and glandular tissue, is by having a mammogram. Patient advocates have pushed for state laws requiring that mammography providers tell omen about breast density when they send out their mammogram results. Connecticut was the first state to pass a breast density notification law, in 2009. Since then, \u003ca href=\"http://www.diagnosticimaging.com/breast-imaging/breast-density-notification-laws-state-interactive-map\" target=\"_blank\">24 states\u003c/a> have followed. (California's law \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/29/californias-breast-density-notification-law-goes-into-effect/\" target=\"_blank\">went into effect\u003c/a> in 2013.)\u003c/p>\n\u003cp>[contextly_sidebar id=\"GOvlJ5efx21GCpgoG3fWFBrHlGE8OFXe\"]In this study, researchers analyzed the language and content of notifications in 23 states. They found wide variation in how the information was presented. Some states mention increased cancer risk; some recommend additional screening (such as ultrasound or MRI); and some advise women to consult their physician. But there was no uniformity.\u003c/p>\n\u003cp>Even more worrisome, researchers found that in many states the information was just too complicated. About 20 percent of the U.S. population reads below grade level 5. The language presented in the breast density notification was at or above the high school level, on average.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Even just a few high-level words will make the material much more difficult to understand,\" says researcher \u003ca href=\"http://profiles.bu.edu/display/151426\" target=\"_blank\">Nancy Kressin\u003c/a>, director of the Health and Healthcare Disparities Research Program at the Boston University School of Medicine. On average, the literacy level of the notes ranged from high school level to post college graduate school level. So for women with low levels of literacy who are already less likely to get preventive screening, Kressin says these letters could \"increase anxiety and confusion.\"\u003c/p>\n\u003cp>Take New Jersey. Kressin says that about 17 percent of the state's population has low literacy skills, yet the breast density notification reads like a graduate-level textbook. Complex terminology or jargon is in italics:\u003c/p>\n\u003cblockquote>\u003cp>If your mammogram \u003cem>demonstrates\u003c/em> that you have dense breast tissue which could \u003cem>hide small abnormalities\u003c/em>, you might benefit from \u003cem>supplementary\u003c/em> screening tests which can include a breast \u003cem>ultrasound\u003c/em> screening or a breast \u003cem>MRI examination\u003c/em>, or both, depending on your individual risk factors.\u003c/p>\u003c/blockquote>\n\u003cp>The state of Alabama did far better. About 15 percent of state residents lack basic literacy skills, says Kressin, and the notification was written at 7\u003csup>th-\u003c/sup>grade literacy levels:\u003c/p>\n\u003cblockquote>\u003cp>Your mammogram shows that your breast tissue is dense. Dense breast tissue is common and is not abnormal. However, dense breast tissue may make it harder to find cancer on a mammogram and may also be associated with an increased risk of breast cancer. This information about the result of your mammogram is given to you to raise your awareness. Use this information to talk to your doctor about your own risks for breast cancer. At that time, ask your doctor if more screening tests might be useful, based on your risk. A report of your results was sent to your physician.\u003c/p>\u003c/blockquote>\n\u003cp>[contextly_sidebar id=\"aRjqn5HMeCAtAuqwU6qeuY8l1pJthoJm\"]The information is clear and precise, and the recommendation to discuss with the doctor is straightforward and simple.\u003c/p>\n\u003cp>Connecticut and Louisiana's notifications were written at college-level writing. California seems to have done better. The Golden State's letter is written at about an 8th grade level.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Kressin says the goal of the breast density notifications is to get every woman to consult with her doctor about her individual risk factors for cancer, because the answer might be that no more screening is needed. \"We think those conversations should include benefits and possible harms of additional screening including additional exposure to radiation, additional cost, anxiety and even unneeded biopsies,\" she says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Letters+Telling+Women+About+Breast+Density+Are+Often+Too+Darn+Dense&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Half of states -- including California -- require that women who get mammograms be notified if they have dense breasts because it increases cancer risk. But the letters are often jargony and hard to understand, a study finds.","status":"publish","parent":0,"modified":1461690949,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":15,"wordCount":721},"headData":{"title":"Letters Telling Women About Breast Density Are Often Too Darn Dense | KQED","description":"Half of states -- including California -- require that women who get mammograms be notified if they have dense breasts because it increases cancer risk. But the letters are often jargony and hard to understand, a study finds.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Letters Telling Women About Breast Density Are Often Too Darn Dense","datePublished":"2016-04-26T16:49:52.000Z","dateModified":"2016-04-26T17:15:49.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"176993 http://ww2.kqed.org/stateofhealth/?p=176993","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/04/26/letters-telling-women-about-breast-density-are-often-too-darn-dense/","disqusTitle":"Letters Telling Women About Breast Density Are Often Too Darn Dense","nprImageCredit":"National Cancer Institute/Science Faction","nprByline":"Patti Neighmond\u003cbr />\u003ca href=\"http://www.npr.org/sections/health-shots/\">NPR Shots\u003c/a>","nprImageAgency":"Corbis","nprStoryId":"475624010","nprApiLink":"http://api.npr.org/query?id=475624010&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2016/04/26/475624010/letters-telling-women-about-breast-density-are-often-too-darn-dense?ft=nprml&f=475624010","nprRetrievedStory":"1","nprPubDate":"Tue, 26 Apr 2016 11:05:00 -0400","nprStoryDate":"Tue, 26 Apr 2016 11:05:25 -0400","nprLastModifiedDate":"Tue, 26 Apr 2016 11:05:25 -0400","path":"/stateofhealth/176993/letters-telling-women-about-breast-density-are-often-too-darn-dense","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Over the past decade, California and many states \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/29/californias-breast-density-notification-law-goes-into-effect/\" target=\"_blank\">have passed laws\u003c/a> intended to help women understand the results of their breast cancer screening mammograms if they have dense breasts. But those notifications can be downright confusing and may, in fact, cause more misunderstanding than understanding.\u003c/p>\n\u003cp>A \u003ca href=\"http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2016.1712\" target=\"_blank\">study\u003c/a> published Tuesday in \u003cem>JAMA\u003c/em>, the journal of the American Medical Association, finds the wording of some notifications so complex that only a PhD could understand them. This lack of simple, direct information could lead to greater health disparities in diagnosis and treatment of breast cancer, since having dense breasts makes it a bit more likely that a woman will have \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923218/\" target=\"_blank\">breast cancer\u003c/a>, and also that cancer could be missed on a mammogram.\u003c/p>\n\u003cp>Breast density is normal and common, but the only way a woman can find out that she has dense breasts, which have more fibrous and glandular tissue, is by having a mammogram. Patient advocates have pushed for state laws requiring that mammography providers tell omen about breast density when they send out their mammogram results. Connecticut was the first state to pass a breast density notification law, in 2009. Since then, \u003ca href=\"http://www.diagnosticimaging.com/breast-imaging/breast-density-notification-laws-state-interactive-map\" target=\"_blank\">24 states\u003c/a> have followed. (California's law \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/29/californias-breast-density-notification-law-goes-into-effect/\" target=\"_blank\">went into effect\u003c/a> in 2013.)\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>In this study, researchers analyzed the language and content of notifications in 23 states. They found wide variation in how the information was presented. Some states mention increased cancer risk; some recommend additional screening (such as ultrasound or MRI); and some advise women to consult their physician. But there was no uniformity.\u003c/p>\n\u003cp>Even more worrisome, researchers found that in many states the information was just too complicated. About 20 percent of the U.S. population reads below grade level 5. The language presented in the breast density notification was at or above the high school level, on average.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Even just a few high-level words will make the material much more difficult to understand,\" says researcher \u003ca href=\"http://profiles.bu.edu/display/151426\" target=\"_blank\">Nancy Kressin\u003c/a>, director of the Health and Healthcare Disparities Research Program at the Boston University School of Medicine. On average, the literacy level of the notes ranged from high school level to post college graduate school level. So for women with low levels of literacy who are already less likely to get preventive screening, Kressin says these letters could \"increase anxiety and confusion.\"\u003c/p>\n\u003cp>Take New Jersey. Kressin says that about 17 percent of the state's population has low literacy skills, yet the breast density notification reads like a graduate-level textbook. Complex terminology or jargon is in italics:\u003c/p>\n\u003cblockquote>\u003cp>If your mammogram \u003cem>demonstrates\u003c/em> that you have dense breast tissue which could \u003cem>hide small abnormalities\u003c/em>, you might benefit from \u003cem>supplementary\u003c/em> screening tests which can include a breast \u003cem>ultrasound\u003c/em> screening or a breast \u003cem>MRI examination\u003c/em>, or both, depending on your individual risk factors.\u003c/p>\u003c/blockquote>\n\u003cp>The state of Alabama did far better. About 15 percent of state residents lack basic literacy skills, says Kressin, and the notification was written at 7\u003csup>th-\u003c/sup>grade literacy levels:\u003c/p>\n\u003cblockquote>\u003cp>Your mammogram shows that your breast tissue is dense. Dense breast tissue is common and is not abnormal. However, dense breast tissue may make it harder to find cancer on a mammogram and may also be associated with an increased risk of breast cancer. This information about the result of your mammogram is given to you to raise your awareness. Use this information to talk to your doctor about your own risks for breast cancer. At that time, ask your doctor if more screening tests might be useful, based on your risk. A report of your results was sent to your physician.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The information is clear and precise, and the recommendation to discuss with the doctor is straightforward and simple.\u003c/p>\n\u003cp>Connecticut and Louisiana's notifications were written at college-level writing. California seems to have done better. The Golden State's letter is written at about an 8th grade level.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Kressin says the goal of the breast density notifications is to get every woman to consult with her doctor about her individual risk factors for cancer, because the answer might be that no more screening is needed. \"We think those conversations should include benefits and possible harms of additional screening including additional exposure to radiation, additional cost, anxiety and even unneeded biopsies,\" she says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Letters+Telling+Women+About+Breast+Density+Are+Often+Too+Darn+Dense&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/176993/letters-telling-women-about-breast-density-are-often-too-darn-dense","authors":["byline_stateofhealth_176993"],"categories":["stateofhealth_13"],"tags":["stateofhealth_46","stateofhealth_397"],"featImg":"stateofhealth_176994","label":"stateofhealth"},"stateofhealth_105583":{"type":"posts","id":"stateofhealth_105583","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"105583","score":null,"sort":[1447089315000]},"guestAuthors":[],"slug":"hormones-may-help-younger-women-with-menopause-symptoms","title":"Hormones May Help Younger Women With Menopause Symptoms","publishDate":1447089315,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>For Linnea Duvall, a marriage and family therapist who lives and works in Santa Monica, Calif., the symptoms of menopause started when she turned 50. She felt more irritable, a smidge heavier and she started waking up two to three times a night.\u003c/p>\n\u003cp>And then she had a hot flash.\u003c/p>\n\u003cp>\"It felt like a nuclear bomb went off right behind my belly button,\" she says. \"The radiation went out to my fingertips, the tops of my toes, the top of my head and the ends of my hair.\"\u003c/p>\n\u003cp>But Duvall would not consider \u003ca href=\"https://www.nlm.nih.gov/medlineplus/ency/article/007111.htm\">hormone therapy\u003c/a> to control the flashes. She was terrified. She says she can sum up her fear in two words: \"breast cancer.\"\u003c/p>\n\u003cp>To understand why she feels this way, we have to look back a few decades to a time when many postmenopausal women were taking hormones to treat symptoms. At the time, hormones were thought of as something of an elixir of youth that could also prevent chronic disease. So women took hormones indefinitely. But a huge \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1745676\">study\u003c/a> in 2002 changed everything.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Known as the Women's Health Initiative, it found that taking estrogen plus progestin hormone replacement therapy actually increased a woman's risk of heart disease and breast cancer. The study had a huge effect. Within months the number of women taking hormones in the U.S. dropped by almost half. Today, only about 10 percent of women aged 50 or over are on hormone therapy.\u003c/p>\n\u003cp>That was a huge overreaction, according to \u003ca href=\"http://www.utianllc.com/\">Dr. Wulf Utian\u003c/a>, director of the \u003ca href=\"http://www.menopause.org/\">North American Menopause Society\u003c/a>, particularly in light of more recent findings. A more detailed \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24084921\">analysis\u003c/a> of the Women's Health Initiative data found that age really made a difference in heart disease risk. For women who started hormone therapy between the ages of 50 and 59, there was a protective \u003ca href=\"http://www.futuremedicine.com/doi/full/10.2217/whe.15.24\">benefit\u003c/a>, says \u003ca href=\"http://www.hsph.harvard.edu/joann-manson/\">Dr. JoAnn Manson\u003c/a>, one of the lead investigators of the study and a professor of medicine at the Harvard T.H. Chan School of Public Health.\u003c/p>\n\u003cp>Women who take hormones earlier after the onset of menopause may experience less plaque, blood vessel blockage, and \u003ca href=\"http://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis\">atherosclerosis,\u003c/a> Manson says, \"And possibly even a reduced risk of heart attack. But for women over the age of 60 the benefit seems to disappear. This is probably because older women already have plaque buildup, Manson says.\u003c/p>\n\u003cp>Researchers in Denmark also \u003ca href=\"http://www.bmj.com/content/345/bmj.e6409\">found\u003c/a> that age makes a difference. They looked at 1,000 healthy women between the ages of 45 and 58. The women who took hormones experienced significantly reduced risk of mortality, heart failure and heart attack.\u003c/p>\n\u003cp>Today, menopausal women are young in the scale of things, says Dr. Wulf Utian, noting that menopause typically starts between age 45 and 60. If women start hormones within in a few years of menopause or even a few years before, he says there are numerous benefits beyond controlling hot flashes. These benefits include reduced risk of bone fractures, reduced risk of diabetes and for many women, an overall boost in their quality of life — meaning better sleep, maintenance of libido and more comfortable sex.\u003c/p>\n\u003cp>\"In my opinion, the best recommendation would be for some form of hormone therapy,\" says Utian.\u003c/p>\n\u003cp>But here's the worry. Studies do confirm an increased risk of breast cancer among women taking hormones, regardless of age. Manson says any risk is worrisome, but it's important to put this risk in perspective and understand that it is actually small.\u003c/p>\n\u003cp>\"For every 1,000 women per year not using hormone therapy about 3 would develop breast cancer,\" Manson says. \"And among every 1,000 women using hormone therapy about 4 of them would develop breast cancer, so that's about 1 extra case of breast cancer per 1,000 women per year on hormone therapy.\"\u003c/p>\n\u003cp>This is where things get tricky. There is no consensus in the medical community on whether the symptom relief is worth the extra risk. Different doctors interpret risk differently. And if you're a breast oncologist like \u003ca href=\"http://www.labiomed.org/researchers/rowan-t-chlebowski-md-phd\">Dr. Rowan Chlebowski\u003c/a> at Harbor UCLA Medical Center, any risk is too much.\u003c/p>\n\u003cp>\"It's a disease that I see every day,\" Chlebowsi says. \"So I think that's something to be avoided.\"\u003c/p>\n\u003cp>Chlebowski a\u003ca href=\"#_msocom_1\" name=\"_msoanchor_1\">\u003c/a>dds that hormone therapy also makes it more difficult to read mammograms, since hormones make the breast denser. If mammograms are more difficult to read, it's harder to diagnose breast cancer in its earliest stage when it's most treatable.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So bottom line — this really \u003cem>is\u003c/em> an individual decision between a woman and her doctor, a decision based on how much risk a woman can tolerate in favor of symptom control and other potential benefits. Researcher Joann Manson says if a woman chooses hormone therapy, then the lowest possible dose for the shortest amount of time is probably safe for most women.\u003c/p>\n\u003chr>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hormones+May+Help+Younger+Women+With+Menopause+Symptoms&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"Thirteen years after a study on hormone therapy was halted due to concerns about cancer risk, some doctors say it's safe for most younger women if they take hormones short term.","status":"publish","parent":0,"modified":1447182019,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":817},"headData":{"title":"Hormones May Help Younger Women With Menopause Symptoms | KQED","description":"Thirteen years after a study on hormone therapy was halted due to concerns about cancer risk, some doctors say it's safe for most younger women if they take hormones short term.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Hormones May Help Younger Women With Menopause Symptoms","datePublished":"2015-11-09T17:15:15.000Z","dateModified":"2015-11-10T19:00:19.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"105583 http://ww2.kqed.org/stateofhealth/?p=105583","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/11/09/hormones-may-help-younger-women-with-menopause-symptoms/","disqusTitle":"Hormones May Help Younger Women With Menopause Symptoms","nprByline":"Patti Neighmond","nprStoryId":"454710392","nprApiLink":"http://api.npr.org/query?id=454710392&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/11/09/454710392/hormones-may-help-younger-women-with-menopause-symptoms?ft=nprml&f=454710392","nprRetrievedStory":"1","nprPubDate":"Mon, 09 Nov 2015 11:08:00 -0500","nprStoryDate":"Mon, 09 Nov 2015 04:35:00 -0500","nprLastModifiedDate":"Mon, 09 Nov 2015 04:36:02 -0500","nprAudio":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/11/20151109_me_hormones_may_help_younger_women_with_menopause_symptoms.mp3?orgId=1&topicId=1128&d=301&p=3&story=454710392&t=progseg&e=455279656&seg=6&ft=nprml&f=454710392","nprAudioM3u":"http://api.npr.org/m3u/1455286480-e4959b.m3u?orgId=1&topicId=1128&d=301&p=3&story=454710392&t=progseg&e=455279656&seg=6&ft=nprml&f=454710392","path":"/stateofhealth/105583/hormones-may-help-younger-women-with-menopause-symptoms","audioUrl":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/11/20151109_me_hormones_may_help_younger_women_with_menopause_symptoms.mp3?orgId=1&topicId=1128&d=301&p=3&story=454710392&t=progseg&e=455279656&seg=6&ft=nprml&f=454710392","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>For Linnea Duvall, a marriage and family therapist who lives and works in Santa Monica, Calif., the symptoms of menopause started when she turned 50. She felt more irritable, a smidge heavier and she started waking up two to three times a night.\u003c/p>\n\u003cp>And then she had a hot flash.\u003c/p>\n\u003cp>\"It felt like a nuclear bomb went off right behind my belly button,\" she says. \"The radiation went out to my fingertips, the tops of my toes, the top of my head and the ends of my hair.\"\u003c/p>\n\u003cp>But Duvall would not consider \u003ca href=\"https://www.nlm.nih.gov/medlineplus/ency/article/007111.htm\">hormone therapy\u003c/a> to control the flashes. She was terrified. She says she can sum up her fear in two words: \"breast cancer.\"\u003c/p>\n\u003cp>To understand why she feels this way, we have to look back a few decades to a time when many postmenopausal women were taking hormones to treat symptoms. At the time, hormones were thought of as something of an elixir of youth that could also prevent chronic disease. So women took hormones indefinitely. But a huge \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1745676\">study\u003c/a> in 2002 changed everything.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Known as the Women's Health Initiative, it found that taking estrogen plus progestin hormone replacement therapy actually increased a woman's risk of heart disease and breast cancer. The study had a huge effect. Within months the number of women taking hormones in the U.S. dropped by almost half. Today, only about 10 percent of women aged 50 or over are on hormone therapy.\u003c/p>\n\u003cp>That was a huge overreaction, according to \u003ca href=\"http://www.utianllc.com/\">Dr. Wulf Utian\u003c/a>, director of the \u003ca href=\"http://www.menopause.org/\">North American Menopause Society\u003c/a>, particularly in light of more recent findings. A more detailed \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24084921\">analysis\u003c/a> of the Women's Health Initiative data found that age really made a difference in heart disease risk. For women who started hormone therapy between the ages of 50 and 59, there was a protective \u003ca href=\"http://www.futuremedicine.com/doi/full/10.2217/whe.15.24\">benefit\u003c/a>, says \u003ca href=\"http://www.hsph.harvard.edu/joann-manson/\">Dr. JoAnn Manson\u003c/a>, one of the lead investigators of the study and a professor of medicine at the Harvard T.H. Chan School of Public Health.\u003c/p>\n\u003cp>Women who take hormones earlier after the onset of menopause may experience less plaque, blood vessel blockage, and \u003ca href=\"http://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis\">atherosclerosis,\u003c/a> Manson says, \"And possibly even a reduced risk of heart attack. But for women over the age of 60 the benefit seems to disappear. This is probably because older women already have plaque buildup, Manson says.\u003c/p>\n\u003cp>Researchers in Denmark also \u003ca href=\"http://www.bmj.com/content/345/bmj.e6409\">found\u003c/a> that age makes a difference. They looked at 1,000 healthy women between the ages of 45 and 58. The women who took hormones experienced significantly reduced risk of mortality, heart failure and heart attack.\u003c/p>\n\u003cp>Today, menopausal women are young in the scale of things, says Dr. Wulf Utian, noting that menopause typically starts between age 45 and 60. If women start hormones within in a few years of menopause or even a few years before, he says there are numerous benefits beyond controlling hot flashes. These benefits include reduced risk of bone fractures, reduced risk of diabetes and for many women, an overall boost in their quality of life — meaning better sleep, maintenance of libido and more comfortable sex.\u003c/p>\n\u003cp>\"In my opinion, the best recommendation would be for some form of hormone therapy,\" says Utian.\u003c/p>\n\u003cp>But here's the worry. Studies do confirm an increased risk of breast cancer among women taking hormones, regardless of age. Manson says any risk is worrisome, but it's important to put this risk in perspective and understand that it is actually small.\u003c/p>\n\u003cp>\"For every 1,000 women per year not using hormone therapy about 3 would develop breast cancer,\" Manson says. \"And among every 1,000 women using hormone therapy about 4 of them would develop breast cancer, so that's about 1 extra case of breast cancer per 1,000 women per year on hormone therapy.\"\u003c/p>\n\u003cp>This is where things get tricky. There is no consensus in the medical community on whether the symptom relief is worth the extra risk. Different doctors interpret risk differently. And if you're a breast oncologist like \u003ca href=\"http://www.labiomed.org/researchers/rowan-t-chlebowski-md-phd\">Dr. Rowan Chlebowski\u003c/a> at Harbor UCLA Medical Center, any risk is too much.\u003c/p>\n\u003cp>\"It's a disease that I see every day,\" Chlebowsi says. \"So I think that's something to be avoided.\"\u003c/p>\n\u003cp>Chlebowski a\u003ca href=\"#_msocom_1\" name=\"_msoanchor_1\">\u003c/a>dds that hormone therapy also makes it more difficult to read mammograms, since hormones make the breast denser. If mammograms are more difficult to read, it's harder to diagnose breast cancer in its earliest stage when it's most treatable.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So bottom line — this really \u003cem>is\u003c/em> an individual decision between a woman and her doctor, a decision based on how much risk a woman can tolerate in favor of symptom control and other potential benefits. Researcher Joann Manson says if a woman chooses hormone therapy, then the lowest possible dose for the shortest amount of time is probably safe for most women.\u003c/p>\n\u003chr>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hormones+May+Help+Younger+Women+With+Menopause+Symptoms&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/105583/hormones-may-help-younger-women-with-menopause-symptoms","authors":["byline_stateofhealth_105583"],"categories":["stateofhealth_12","stateofhealth_13"],"tags":["stateofhealth_46"],"featImg":"stateofhealth_105584","label":"stateofhealth"},"stateofhealth_95854":{"type":"posts","id":"stateofhealth_95854","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"95854","score":null,"sort":[1445459442000]},"guestAuthors":[],"slug":"how-to-untangle-conflicting-mammogram-advice","title":"How to Untangle Conflicting Mammogram Advice","publishDate":1445459442,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>Stephanie Nichols is a stay-at-home mom in Boston. She's 44 now and says she first thought about getting a mammogram when she turned 40.\u003c/p>\n\u003cp>\"I had heard from a number of friends all around the same age that they're all getting mammograms,\" she says. So it came as no surprise when her doctor brought up the topic at her next routine exam.\u003c/p>\n\u003cp>But what was surprising, she says, was that, after discussing family history and personal health, her doctor determined that because Nichols was not at high risk for getting breast cancer, it was probably too soon to get that first scan. Together, they decided to postpone her first mammogram screening test until she was 45.\u003c/p>\n\u003cp>Nichols says she felt comfortable with that decision, \"knowing that my risk for breast cancer was low compared to the risk of having to have more invasive procedures such as biopsies or lumpectomies.\"\u003c/p>\n\u003cp>She's right about the statistics. Researchers say that, across a 10-year period of getting annual mammograms, women overall have a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3209800/\" target=\"_blank\">50-50 chance\u003c/a> of being called back at least once for further testing that turns up nothing cancerous.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And that's one reason why the American Cancer Society \u003ca href=\"http://www.cancer.org/cancer/news/specialcoverage/american-cancer-society-breast-cancer-screening-guidelines\" target=\"_blank\">changed\u003c/a> its advice Tuesday. It now recommends that instead of getting that first screening mammogram at age 40, women who don't have an increased risk for breast cancer can start the screening later — at age 45.\u003c/p>\n\u003cp>[contextly_sidebar id=\"jZFyNZkROyO3IS2b9QQ0aXRy5Ns0o0a2\"]But even that advice starts the screening too soon, according to the U.S. Preventive Services Task Force, which still advises most women of average risk to \u003ca href=\"http://screeningforbreastcancer.org/\" target=\"_blank\">wait till they're 50\u003c/a>. Meanwhile, the American College of Obstetricians and Gynecologists still suggests most women get their first screening \u003ca href=\"http://www.acog.org/Patients/FAQs/Mammography-and-Other-Screening-Tests-for-Breast-Problems\" target=\"_blank\">at 40\u003c/a>. So, which advice is best for you?\u003c/p>\n\u003cp>Dr. Lydia Pace is an internist and primary care doctor at Brigham and Women's Hospital in Boston and describes a \"really wide range in the way women approach this question.\" She says some women come in already knowing they want to start screening at age 40; some ask about screening even before age 40; and some are seeking a more nuanced conversation with the doctor about the particulars of their situation.\u003c/p>\n\u003cp>And Dr. Pace says that discussion with your doctor is absolutely the best approach. If you're at higher risk than average — if your mother or sisters or aunts had breast cancer, for example — it might be reasonable to start screening at 40.\u003c/p>\n\u003cp>Other women who are very worried about getting breast cancer may reasonably start at 40, too, Pace says. This might include some women, for example, who have had strong personal experiences with family or friends who got the illness.\u003c/p>\n\u003cp>\"That may be a much more powerful influence for them than any conversation we can have,\" says Pace.\u003c/p>\n\u003cp>And that's OK, she says. These women could reasonably decide that, for them, the increased peace of mind they'll get with a clear mammogram outweighs the increased risk that they'll also have to undergo further expensive scans, unnecessary biopsies and other testing.\u003c/p>\n\u003cp>[contextly_sidebar id=\"TaYE37DxnIHvG7womU8kUBj46TS6yI11\"]If you wish the evidence about when and how often to screen for breast cancer were more clear-cut, or that the leading groups of doctors offering advice could get on the same page, you're not alone. Lots of doctors are frustrated too.\u003c/p>\n\u003cp>Dr. Laura Esserman, who directs the UC San Francisco Breast Cancer Center, notes that every year, roughly 40,000 women die of breast cancer. What's most important now, she says, is putting energy into finding reliable solutions instead of \"arguing about it.\"\u003c/p>\n\u003cp>Part of the problem, she says, is that the data everyone's basing their argument and recommendations on is 30 to 40 years old. She says the studies \"were done before we had modern treatments for breast cancer, before we knew about the different kinds of breast cancer, before we understood a lot about breast cancer risk.\"\u003c/p>\n\u003cp>\"And so it's high time we do a modern trial where we put some new ideas to the test,\" Esserman says.\u003c/p>\n\u003cp>She recently received a grant to see whether a personalized approach, like the one Stephanie Nichols worked out with her doctor, is as safe and effective at catching aggressive cancers as yearly mammograms starting at age 40.\u003c/p>\n\u003cp>In the meantime, when should women \u003cem>stop\u003c/em> getting screening mammograms? That too, for now, depends on whom you ask.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+Is+Mammogram+Advice+Still+Such+A+Tangle%3F+Ask+Your+Doctor&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"Leading groups don't agree about when and how often women should get a screening mammogram. Your history and preferences can guide you.","status":"publish","parent":0,"modified":1445464355,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":759},"headData":{"title":"How to Untangle Conflicting Mammogram Advice | KQED","description":"Leading groups don't agree about when and how often women should get a screening mammogram. Your history and preferences can guide you.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"How to Untangle Conflicting Mammogram Advice","datePublished":"2015-10-21T20:30:42.000Z","dateModified":"2015-10-21T21:52:35.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"95854 http://ww2.kqed.org/stateofhealth/?p=95854","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/10/21/how-to-untangle-conflicting-mammogram-advice/","disqusTitle":"How to Untangle Conflicting Mammogram Advice","source":"NPR","sourceUrl":"http://www.npr.org/sections/health-shots/2015/10/21/450333627/why-is-mammogram-advice-still-such-a-tangle-ask-your-doctor","nprByline":"Patti Neighmond","nprStoryId":"450333627","nprApiLink":"http://api.npr.org/query?id=450333627&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/10/21/450333627/why-is-mammogram-advice-still-such-a-tangle-ask-your-doctor?ft=nprml&f=450333627","nprRetrievedStory":"1","nprPubDate":"Wed, 21 Oct 2015 10:42:00 -0400","nprStoryDate":"Wed, 21 Oct 2015 05:12:00 -0400","nprLastModifiedDate":"Wed, 21 Oct 2015 10:42:33 -0400","nprAudio":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/10/20151021_me_why_is_mammogram_advice_still_such_a_tangle_ask_your_doctor.mp3?orgId=1&topicId=1128&d=229&p=3&story=450333627&t=progseg&e=450461078&seg=20&ft=nprml&f=450333627","nprAudioM3u":"http://api.npr.org/m3u/1450464773-f0bc0b.m3u?orgId=1&topicId=1128&d=229&p=3&story=450333627&t=progseg&e=450461078&seg=20&ft=nprml&f=450333627","path":"/stateofhealth/95854/how-to-untangle-conflicting-mammogram-advice","audioUrl":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/10/20151021_me_why_is_mammogram_advice_still_such_a_tangle_ask_your_doctor.mp3?orgId=1&topicId=1128&d=229&p=3&story=450333627&t=progseg&e=450461078&seg=20&ft=nprml&f=450333627","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Stephanie Nichols is a stay-at-home mom in Boston. She's 44 now and says she first thought about getting a mammogram when she turned 40.\u003c/p>\n\u003cp>\"I had heard from a number of friends all around the same age that they're all getting mammograms,\" she says. So it came as no surprise when her doctor brought up the topic at her next routine exam.\u003c/p>\n\u003cp>But what was surprising, she says, was that, after discussing family history and personal health, her doctor determined that because Nichols was not at high risk for getting breast cancer, it was probably too soon to get that first scan. Together, they decided to postpone her first mammogram screening test until she was 45.\u003c/p>\n\u003cp>Nichols says she felt comfortable with that decision, \"knowing that my risk for breast cancer was low compared to the risk of having to have more invasive procedures such as biopsies or lumpectomies.\"\u003c/p>\n\u003cp>She's right about the statistics. Researchers say that, across a 10-year period of getting annual mammograms, women overall have a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3209800/\" target=\"_blank\">50-50 chance\u003c/a> of being called back at least once for further testing that turns up nothing cancerous.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And that's one reason why the American Cancer Society \u003ca href=\"http://www.cancer.org/cancer/news/specialcoverage/american-cancer-society-breast-cancer-screening-guidelines\" target=\"_blank\">changed\u003c/a> its advice Tuesday. It now recommends that instead of getting that first screening mammogram at age 40, women who don't have an increased risk for breast cancer can start the screening later — at age 45.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>But even that advice starts the screening too soon, according to the U.S. Preventive Services Task Force, which still advises most women of average risk to \u003ca href=\"http://screeningforbreastcancer.org/\" target=\"_blank\">wait till they're 50\u003c/a>. Meanwhile, the American College of Obstetricians and Gynecologists still suggests most women get their first screening \u003ca href=\"http://www.acog.org/Patients/FAQs/Mammography-and-Other-Screening-Tests-for-Breast-Problems\" target=\"_blank\">at 40\u003c/a>. So, which advice is best for you?\u003c/p>\n\u003cp>Dr. Lydia Pace is an internist and primary care doctor at Brigham and Women's Hospital in Boston and describes a \"really wide range in the way women approach this question.\" She says some women come in already knowing they want to start screening at age 40; some ask about screening even before age 40; and some are seeking a more nuanced conversation with the doctor about the particulars of their situation.\u003c/p>\n\u003cp>And Dr. Pace says that discussion with your doctor is absolutely the best approach. If you're at higher risk than average — if your mother or sisters or aunts had breast cancer, for example — it might be reasonable to start screening at 40.\u003c/p>\n\u003cp>Other women who are very worried about getting breast cancer may reasonably start at 40, too, Pace says. This might include some women, for example, who have had strong personal experiences with family or friends who got the illness.\u003c/p>\n\u003cp>\"That may be a much more powerful influence for them than any conversation we can have,\" says Pace.\u003c/p>\n\u003cp>And that's OK, she says. These women could reasonably decide that, for them, the increased peace of mind they'll get with a clear mammogram outweighs the increased risk that they'll also have to undergo further expensive scans, unnecessary biopsies and other testing.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>If you wish the evidence about when and how often to screen for breast cancer were more clear-cut, or that the leading groups of doctors offering advice could get on the same page, you're not alone. Lots of doctors are frustrated too.\u003c/p>\n\u003cp>Dr. Laura Esserman, who directs the UC San Francisco Breast Cancer Center, notes that every year, roughly 40,000 women die of breast cancer. What's most important now, she says, is putting energy into finding reliable solutions instead of \"arguing about it.\"\u003c/p>\n\u003cp>Part of the problem, she says, is that the data everyone's basing their argument and recommendations on is 30 to 40 years old. She says the studies \"were done before we had modern treatments for breast cancer, before we knew about the different kinds of breast cancer, before we understood a lot about breast cancer risk.\"\u003c/p>\n\u003cp>\"And so it's high time we do a modern trial where we put some new ideas to the test,\" Esserman says.\u003c/p>\n\u003cp>She recently received a grant to see whether a personalized approach, like the one Stephanie Nichols worked out with her doctor, is as safe and effective at catching aggressive cancers as yearly mammograms starting at age 40.\u003c/p>\n\u003cp>In the meantime, when should women \u003cem>stop\u003c/em> getting screening mammograms? That too, for now, depends on whom you ask.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+Is+Mammogram+Advice+Still+Such+A+Tangle%3F+Ask+Your+Doctor&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/95854/how-to-untangle-conflicting-mammogram-advice","authors":["byline_stateofhealth_95854"],"categories":["stateofhealth_13"],"tags":["stateofhealth_46","stateofhealth_176","stateofhealth_397"],"featImg":"stateofhealth_95855","label":"source_stateofhealth_95854"},"stateofhealth_95297":{"type":"posts","id":"stateofhealth_95297","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"95297","score":null,"sort":[1445364406000]},"guestAuthors":[],"slug":"the-american-cancer-society-now-recommends-fewer-mammograms","title":"You Heard It Right: American Cancer Society Now Recommends Fewer Mammograms","publishDate":1445364406,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>In 2009, an influential panel \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening?ds=1&s=breast%20cancer\" target=\"_blank\">updated its guidelines\u003c/a> about mammograms -- when women should start getting them and how frequently -- and ignited a firestorm. More on their recommendations below, but in short, the U.S. Preventive Services Task Force said that average-risk women in their 40s could skip screening and start every-other-year mammograms at age 50.\u003c/p>\n\u003cp>Since then, the august American Cancer Society stayed its course and kept recommending that women get annual mammograms starting at age 40.\u003c/p>\n\u003cp>Until today. Now, in updated guidelines, the American Cancer Society says that women can wait to commence mammograms until age 45 and have them every year until age 54. Starting at 55, women should have them every other year.\u003c/p>\n\u003cp>The recommendation is for women at average risk, not for women with a family history or other factors that would put them at higher risk. The new \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2463262\" target=\"_blank\">guidelines were published \u003c/a>in the journal JAMA.\u003c/p>\n\u003cp>These are \"big changes\" for the American Cancer Society, writes Liz Szabo at \u003ca href=\"http://www.usatoday.com/story/news/2015/10/20/american-cancer-society-say-women-should-start-mammograms-45/74232470/?csp=breakingnews\" target=\"_blank\">USA Today\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>As recently as 1992, the American Cancer Society recommended women get a \"baseline\" mammogram at age 35 to 39, so that doctors would have an image to which to compare their later screening results.\u003c/p>\n\u003cp>The new guidelines reflect the growing recognition that mammograms can do harm, as well as good, said Richard Wender, chief cancer control officer at the American Cancer Society.\u003c/p>\n\u003cp>\"The biggest evolution has been not in the American Cancer Society, but in the science of cancer screening and the evolution of health care in general,\" Wender said.\u003c/p>\u003c/blockquote>\n\u003cp>In another significant change, the cancer society also said doctors should no longer perform routine clinical breast exams. There's no evidence that these exams save lives.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While the cancer society's guidelines move closer to that of the task force that ignited a debate, the two organizations recommendations still differ:\u003c/p>\n\u003cul>\n\u003cli>American Cancer Society -- ages 45-54 annual mammograms; age 55 and for as long as a woman is healthy -- and has a life expectancy of at least 10 years -- every other year\u003c/li>\n\u003cli>U.S. Preventive Services Task Force -- mammograms every other year starting at age 50, until age 74. More research is needed, the group says, on potential benefits in women 75 and older\u003c/li>\n\u003c/ul>\n\u003cp>As the cancer society has moved toward less frequent screening, \u003ca href=\"http://www.npr.org/sections/health-shots/2015/10/20/449920789/cancer-group-now-says-most-mammograms-can-wait-till-45\" target=\"_blank\">Rob Stein at NPR reports\u003c/a> that some experts hope that it will reduce confusion in women:\u003c/p>\n\u003cblockquote>\u003cp>\"There really is not a single answer to the question: Should I have a mammogram?\" says \u003ca href=\"http://www.hcp.med.harvard.edu/faculty/core/nancy-keating-md-mph\" target=\"_blank\">Nancy Keating\u003c/a>, a professor of health care policy at Harvard Medical School and a physician at the Brigham & Women's Hospital.\u003c/p>\n\u003cp>\"It really involves looking at each patient individually,\" she says, \"thinking about their risk of developing breast cancer and thinking about the harms.\" She co-authored an \u003ca href=\"http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2015.13086\" target=\"_blank\">editorial\u003c/a> published with the new guidelines.\u003c/p>\n\u003cp>But it doesn't look like the new guidelines will end the debate. The American College of Radiology and the Society of Breast Imaging, for example, still recommend annual mammography beginning at age 40. Later, less frequent screening could be risky, they say.\u003c/p>\n\u003cp>\"I am personally concerned as a woman and as a person heavily involved in breast cancer screening [that] there will be lives that we could save that will be lost,\" says \u003ca href=\"http://www.sw.org/Dr-Debra-L-Monticciolo\" target=\"_blank\">Dr. Debra Monticciolo\u003c/a>, a professor of radiology at Texas A&M Health Science Center College of Medicine. She chairs the radiology college's commission on breast imaging.\u003c/p>\u003c/blockquote>\n\u003cp>[contextly_sidebar id=\"rZvfCYBX7jHggiQhhG0bWHsaVear3MwO\"]While most women grasp the benefit of cancer screening, the harms of mammograms are likely less well-known to the average patient. Denise Grady at the New York Times outlined the risk of \"false positives,\" a finding on a mammogram which is suspicious, but only through additional testing, often including biopsies, can the finding be determined not to be cancer. From\u003ca href=\"http://www.nytimes.com/2015/10/21/health/breast-cancer-screening-guidelines.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news&_r=0\" target=\"_blank\"> the Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>A 2011 study cited in the article explaining the new [cancer society] guidelines found that 61 percent of women who had yearly mammograms starting at age 40 had at least one false positive by the time they were 50. Being tested every other year instead of every year can cut the false positive rate significantly, ... to about 42 percent from 61 percent.\u003c/p>\n\u003cp class=\"story-body-text story-content\">Some women consider false positives a small price to pay for the chance of identifying a cancer early. Others find being called back for more tests too nerve-racking.\u003c/p>\n\u003cp class=\"story-body-text story-content\">Another potential risk of mammography is overdiagnosis, meaning that some of the tiny cancers it finds might never progress or threaten the patient’s life. But because there is now no way to be sure which will turn dangerous, they are treated anyway.\u003c/p>\n\u003c/blockquote>\n\u003cp>The treatment can include surgery, radiation and chemotherapy.\u003c/p>\n\u003cp>\u003ca href=\"http://bcaction.org/2015/10/20/american-cancer-society-screening-guidelines-for-breast-cancer-baby-step-toward-evidence-based-recommendations/\" target=\"_blank\">In a statement,\u003c/a> the San Francisco-based Breast Cancer Action, which has long advocated for changes in screening guidelines, said it welcomed the \"long overdue step\" by the cancer society.\u003c/p>\n\u003cp>“After years of relentlessly promoting annual mammography for women age 40 and older and overstating the benefits of early detection, the ACS is finally starting to follow the evidence on the limitations of routine breast cancer screening for women at average risk,” said Karuna Jaggar, executive director of Breast Cancer Action.\u003c/p>\n\u003cp>\"The reality is tens of thousands of women each year would have been spared the harms of overtreatment if the ACS and other large cancer organizations had followed the evidence sooner,\" Jaggar said.\u003c/p>\n\u003cp>The cancer society says women ages 40-44 who wish to have mammograms should be informed of the test's risks and benefits.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force is in the process of \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/breast-cancer-screening1\" target=\"_blank\">updating its guidelines\u003c/a>, especially for women in their 40s, and now says: \"The decision to start screening mammography in women prior to age 50 years should be an individual one.\"\u003c/p>\n\n","blocks":[],"excerpt":"For starters, instead of starting at age 40, the society now recommends that women should start at age 45.","status":"publish","parent":0,"modified":1445396414,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":981},"headData":{"title":"You Heard It Right: American Cancer Society Now Recommends Fewer Mammograms | KQED","description":"For starters, instead of starting at age 40, the society now recommends that women should start at age 45.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"You Heard It Right: American Cancer Society Now Recommends Fewer Mammograms","datePublished":"2015-10-20T18:06:46.000Z","dateModified":"2015-10-21T03:00:14.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"95297 http://ww2.kqed.org/stateofhealth/?p=95297","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/10/20/the-american-cancer-society-now-recommends-fewer-mammograms/","disqusTitle":"You Heard It Right: American Cancer Society Now Recommends Fewer Mammograms","path":"/stateofhealth/95297/the-american-cancer-society-now-recommends-fewer-mammograms","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In 2009, an influential panel \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening?ds=1&s=breast%20cancer\" target=\"_blank\">updated its guidelines\u003c/a> about mammograms -- when women should start getting them and how frequently -- and ignited a firestorm. More on their recommendations below, but in short, the U.S. Preventive Services Task Force said that average-risk women in their 40s could skip screening and start every-other-year mammograms at age 50.\u003c/p>\n\u003cp>Since then, the august American Cancer Society stayed its course and kept recommending that women get annual mammograms starting at age 40.\u003c/p>\n\u003cp>Until today. Now, in updated guidelines, the American Cancer Society says that women can wait to commence mammograms until age 45 and have them every year until age 54. Starting at 55, women should have them every other year.\u003c/p>\n\u003cp>The recommendation is for women at average risk, not for women with a family history or other factors that would put them at higher risk. The new \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2463262\" target=\"_blank\">guidelines were published \u003c/a>in the journal JAMA.\u003c/p>\n\u003cp>These are \"big changes\" for the American Cancer Society, writes Liz Szabo at \u003ca href=\"http://www.usatoday.com/story/news/2015/10/20/american-cancer-society-say-women-should-start-mammograms-45/74232470/?csp=breakingnews\" target=\"_blank\">USA Today\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>As recently as 1992, the American Cancer Society recommended women get a \"baseline\" mammogram at age 35 to 39, so that doctors would have an image to which to compare their later screening results.\u003c/p>\n\u003cp>The new guidelines reflect the growing recognition that mammograms can do harm, as well as good, said Richard Wender, chief cancer control officer at the American Cancer Society.\u003c/p>\n\u003cp>\"The biggest evolution has been not in the American Cancer Society, but in the science of cancer screening and the evolution of health care in general,\" Wender said.\u003c/p>\u003c/blockquote>\n\u003cp>In another significant change, the cancer society also said doctors should no longer perform routine clinical breast exams. There's no evidence that these exams save lives.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While the cancer society's guidelines move closer to that of the task force that ignited a debate, the two organizations recommendations still differ:\u003c/p>\n\u003cul>\n\u003cli>American Cancer Society -- ages 45-54 annual mammograms; age 55 and for as long as a woman is healthy -- and has a life expectancy of at least 10 years -- every other year\u003c/li>\n\u003cli>U.S. Preventive Services Task Force -- mammograms every other year starting at age 50, until age 74. More research is needed, the group says, on potential benefits in women 75 and older\u003c/li>\n\u003c/ul>\n\u003cp>As the cancer society has moved toward less frequent screening, \u003ca href=\"http://www.npr.org/sections/health-shots/2015/10/20/449920789/cancer-group-now-says-most-mammograms-can-wait-till-45\" target=\"_blank\">Rob Stein at NPR reports\u003c/a> that some experts hope that it will reduce confusion in women:\u003c/p>\n\u003cblockquote>\u003cp>\"There really is not a single answer to the question: Should I have a mammogram?\" says \u003ca href=\"http://www.hcp.med.harvard.edu/faculty/core/nancy-keating-md-mph\" target=\"_blank\">Nancy Keating\u003c/a>, a professor of health care policy at Harvard Medical School and a physician at the Brigham & Women's Hospital.\u003c/p>\n\u003cp>\"It really involves looking at each patient individually,\" she says, \"thinking about their risk of developing breast cancer and thinking about the harms.\" She co-authored an \u003ca href=\"http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2015.13086\" target=\"_blank\">editorial\u003c/a> published with the new guidelines.\u003c/p>\n\u003cp>But it doesn't look like the new guidelines will end the debate. The American College of Radiology and the Society of Breast Imaging, for example, still recommend annual mammography beginning at age 40. Later, less frequent screening could be risky, they say.\u003c/p>\n\u003cp>\"I am personally concerned as a woman and as a person heavily involved in breast cancer screening [that] there will be lives that we could save that will be lost,\" says \u003ca href=\"http://www.sw.org/Dr-Debra-L-Monticciolo\" target=\"_blank\">Dr. Debra Monticciolo\u003c/a>, a professor of radiology at Texas A&M Health Science Center College of Medicine. She chairs the radiology college's commission on breast imaging.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>While most women grasp the benefit of cancer screening, the harms of mammograms are likely less well-known to the average patient. Denise Grady at the New York Times outlined the risk of \"false positives,\" a finding on a mammogram which is suspicious, but only through additional testing, often including biopsies, can the finding be determined not to be cancer. From\u003ca href=\"http://www.nytimes.com/2015/10/21/health/breast-cancer-screening-guidelines.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news&_r=0\" target=\"_blank\"> the Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>A 2011 study cited in the article explaining the new [cancer society] guidelines found that 61 percent of women who had yearly mammograms starting at age 40 had at least one false positive by the time they were 50. Being tested every other year instead of every year can cut the false positive rate significantly, ... to about 42 percent from 61 percent.\u003c/p>\n\u003cp class=\"story-body-text story-content\">Some women consider false positives a small price to pay for the chance of identifying a cancer early. Others find being called back for more tests too nerve-racking.\u003c/p>\n\u003cp class=\"story-body-text story-content\">Another potential risk of mammography is overdiagnosis, meaning that some of the tiny cancers it finds might never progress or threaten the patient’s life. But because there is now no way to be sure which will turn dangerous, they are treated anyway.\u003c/p>\n\u003c/blockquote>\n\u003cp>The treatment can include surgery, radiation and chemotherapy.\u003c/p>\n\u003cp>\u003ca href=\"http://bcaction.org/2015/10/20/american-cancer-society-screening-guidelines-for-breast-cancer-baby-step-toward-evidence-based-recommendations/\" target=\"_blank\">In a statement,\u003c/a> the San Francisco-based Breast Cancer Action, which has long advocated for changes in screening guidelines, said it welcomed the \"long overdue step\" by the cancer society.\u003c/p>\n\u003cp>“After years of relentlessly promoting annual mammography for women age 40 and older and overstating the benefits of early detection, the ACS is finally starting to follow the evidence on the limitations of routine breast cancer screening for women at average risk,” said Karuna Jaggar, executive director of Breast Cancer Action.\u003c/p>\n\u003cp>\"The reality is tens of thousands of women each year would have been spared the harms of overtreatment if the ACS and other large cancer organizations had followed the evidence sooner,\" Jaggar said.\u003c/p>\n\u003cp>The cancer society says women ages 40-44 who wish to have mammograms should be informed of the test's risks and benefits.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force is in the process of \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/breast-cancer-screening1\" target=\"_blank\">updating its guidelines\u003c/a>, especially for women in their 40s, and now says: \"The decision to start screening mammography in women prior to age 50 years should be an individual one.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/95297/the-american-cancer-society-now-recommends-fewer-mammograms","authors":["240"],"categories":["stateofhealth_13"],"tags":["stateofhealth_46","stateofhealth_176","stateofhealth_461","stateofhealth_397"],"featImg":"stateofhealth_95324","label":"stateofhealth"},"stateofhealth_90042":{"type":"posts","id":"stateofhealth_90042","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"90042","score":null,"sort":[1444241004000]},"guestAuthors":[],"slug":"marin-countys-breast-cancer-rate-has-plummeted-why","title":"Marin County's Breast Cancer Rate Has Plummeted. Why?","publishDate":1444241004,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>The breast cancer rate in Marin County -- once called the highest in the world -- is now at the lowest level since tracking started in 1988 and matches the statewide average, according to a \u003ca href=\"http://www.cpic.org/files/PDF/Cancer_Registry/Cancer_Data_and_Statistics/CPIC_Breast_Cancer_Marin_Update_2015-09-21.pdf\" target=\"_blank\">new analysis. \u003c/a>\u003c/p>\n\u003cp>The question, of course, is why.\u003c/p>\n\u003cp>\"A whole lot of people are scratching their heads over this one,\" said Tina Clarke, an epidemiologist with the Cancer Prevention Institute of California and the study's lead author.\u003c/p>\n\u003cp>To be fair, Clarke can explain part of the decline. But before we get into more detail on that, a bit of history.\u003c/p>\n\u003cp>In 1994, \u003ca href=\"http://www.zerobreastcancer.org/breast-cancer-in-marin\" target=\"_blank\">a report from CPIC \u003c/a>(then called Northern California Cancer Center) identified the high rate of breast cancer in Marin County, compared it to that of countries around the world and concluded that the Marin County rate was the highest.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Women in Marin, an affluent county, have \"a whole cluster of established risk factors for breast cancer,\" Clarke said. These risk factors tend to go along with being more affluent: later age of childbearing, if at all, and higher alcohol consumption. White women are at slightly higher risk of developing breast cancer than are women of other races or ethnicities.\u003c/p>\n\u003cp>Through the 1990s, breast cancer rates for non-Hispanic white women in Marin \u003ca href=\"http://www.marincounty.org/~/media/files/departments/bs/district-4/docs/faq_breast_cancer_in_marin.pdf?la=en\" target=\"_blank\">climbed 60 percent,\u003c/a> compared to 5 percent in other parts of the Bay Area. It reached its peak in 2001.\u003c/p>\n\u003cp>The rate started to fall after a \u003ca href=\"https://www.nhlbi.nih.gov/news/press-releases/2002/nhlbi-stops-trial-of-estrogen-plus-progestin-due-to-increased-breast-cancer-risk-lack-of-overall-benefit\" target=\"_blank\">major study was halted in 2002\u003c/a>, when researchers identified a link between use of hormone replacement therapy and breast cancer. Affluent women were also more likely to use hormone therapy.\u003c/p>\n\u003cp>Women abandoned the hormones in droves, and the breast cancer rate started to fall, in Marin and nationwide.\u003c/p>\n\u003cp>But Marin county's breast cancer rate still exceeded the statewide average until a second drop started in 2007. That's what researchers can't quite account for.\u003c/p>\n\u003cp>Clarke said it's likely due to a host of reasons -- perhaps women are exercising more or losing weight, two other factors that reduce risk of breast cancer. It's also possible women are consuming less alcohol, she said.\u003c/p>\n\u003cp>One factor they know is not responsible: the change in mammography screening guidelines. In 2009, a major government panel, the U.S. Preventive Services Task Force, \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening\" target=\"_blank\">recommended women have fewer mammograms\u003c/a>. Researchers found no evidence that this recommendation has led to less breast cancer being found, in part because the incidence of ductal carcinoma in situ -- or DCIS -- is increasing.\u003c/p>\n\u003cp>\"The increased incidence of \u003cem>in situ \u003c/em>cancer suggests a decline in mammography screening likely is not a key factor contributing to the decline in invasive breast cancer in Marin County,\" Dr. Karly Kerlikowske, a UCSF epidemiologist said in a release.\u003c/p>\n\u003cp>Whatever the reason, \"We're really happy to see things trending in the right direction,\" Clarke said. \"We're obviously delighted to tell women in Marin County that the rates are similar to the rest of the state.\"\u003c/p>\n\u003cp>Since 2001, the breast cancer rate in Marin has dropped 31 percent. Mortality has also sharply declined. Since record-keeping began in 1988, the death rate from breast cancer has dropped 65 percent.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>An interesting footnote: Clarke said that monitoring incidence rates is based on county-level census data. It's highly likely, she said, that similarly affluent areas in California, like Palo Alto or West LA, might have had the same pattern of a higher rate -- fueled at least in part by hormone therapy -- and the decline that Marin has seen.\u003c/p>\n\n","blocks":[],"excerpt":"\"A whole lot of people are scratching their heads over this one,\" study author says.","status":"publish","parent":0,"modified":1444246966,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":589},"headData":{"title":"Marin County's Breast Cancer Rate Has Plummeted. Why? | KQED","description":""A whole lot of people are scratching their heads over this one," study author says.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Marin County's Breast Cancer Rate Has Plummeted. Why?","datePublished":"2015-10-07T18:03:24.000Z","dateModified":"2015-10-07T19:42:46.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"90042 http://ww2.kqed.org/stateofhealth/?p=90042","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/10/07/marin-countys-breast-cancer-rate-has-plummeted-why/","disqusTitle":"Marin County's Breast Cancer Rate Has Plummeted. Why?","path":"/stateofhealth/90042/marin-countys-breast-cancer-rate-has-plummeted-why","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The breast cancer rate in Marin County -- once called the highest in the world -- is now at the lowest level since tracking started in 1988 and matches the statewide average, according to a \u003ca href=\"http://www.cpic.org/files/PDF/Cancer_Registry/Cancer_Data_and_Statistics/CPIC_Breast_Cancer_Marin_Update_2015-09-21.pdf\" target=\"_blank\">new analysis. \u003c/a>\u003c/p>\n\u003cp>The question, of course, is why.\u003c/p>\n\u003cp>\"A whole lot of people are scratching their heads over this one,\" said Tina Clarke, an epidemiologist with the Cancer Prevention Institute of California and the study's lead author.\u003c/p>\n\u003cp>To be fair, Clarke can explain part of the decline. But before we get into more detail on that, a bit of history.\u003c/p>\n\u003cp>In 1994, \u003ca href=\"http://www.zerobreastcancer.org/breast-cancer-in-marin\" target=\"_blank\">a report from CPIC \u003c/a>(then called Northern California Cancer Center) identified the high rate of breast cancer in Marin County, compared it to that of countries around the world and concluded that the Marin County rate was the highest.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Women in Marin, an affluent county, have \"a whole cluster of established risk factors for breast cancer,\" Clarke said. These risk factors tend to go along with being more affluent: later age of childbearing, if at all, and higher alcohol consumption. White women are at slightly higher risk of developing breast cancer than are women of other races or ethnicities.\u003c/p>\n\u003cp>Through the 1990s, breast cancer rates for non-Hispanic white women in Marin \u003ca href=\"http://www.marincounty.org/~/media/files/departments/bs/district-4/docs/faq_breast_cancer_in_marin.pdf?la=en\" target=\"_blank\">climbed 60 percent,\u003c/a> compared to 5 percent in other parts of the Bay Area. It reached its peak in 2001.\u003c/p>\n\u003cp>The rate started to fall after a \u003ca href=\"https://www.nhlbi.nih.gov/news/press-releases/2002/nhlbi-stops-trial-of-estrogen-plus-progestin-due-to-increased-breast-cancer-risk-lack-of-overall-benefit\" target=\"_blank\">major study was halted in 2002\u003c/a>, when researchers identified a link between use of hormone replacement therapy and breast cancer. Affluent women were also more likely to use hormone therapy.\u003c/p>\n\u003cp>Women abandoned the hormones in droves, and the breast cancer rate started to fall, in Marin and nationwide.\u003c/p>\n\u003cp>But Marin county's breast cancer rate still exceeded the statewide average until a second drop started in 2007. That's what researchers can't quite account for.\u003c/p>\n\u003cp>Clarke said it's likely due to a host of reasons -- perhaps women are exercising more or losing weight, two other factors that reduce risk of breast cancer. It's also possible women are consuming less alcohol, she said.\u003c/p>\n\u003cp>One factor they know is not responsible: the change in mammography screening guidelines. In 2009, a major government panel, the U.S. Preventive Services Task Force, \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening\" target=\"_blank\">recommended women have fewer mammograms\u003c/a>. Researchers found no evidence that this recommendation has led to less breast cancer being found, in part because the incidence of ductal carcinoma in situ -- or DCIS -- is increasing.\u003c/p>\n\u003cp>\"The increased incidence of \u003cem>in situ \u003c/em>cancer suggests a decline in mammography screening likely is not a key factor contributing to the decline in invasive breast cancer in Marin County,\" Dr. Karly Kerlikowske, a UCSF epidemiologist said in a release.\u003c/p>\n\u003cp>Whatever the reason, \"We're really happy to see things trending in the right direction,\" Clarke said. \"We're obviously delighted to tell women in Marin County that the rates are similar to the rest of the state.\"\u003c/p>\n\u003cp>Since 2001, the breast cancer rate in Marin has dropped 31 percent. Mortality has also sharply declined. Since record-keeping began in 1988, the death rate from breast cancer has dropped 65 percent.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>An interesting footnote: Clarke said that monitoring incidence rates is based on county-level census data. It's highly likely, she said, that similarly affluent areas in California, like Palo Alto or West LA, might have had the same pattern of a higher rate -- fueled at least in part by hormone therapy -- and the decline that Marin has seen.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/90042/marin-countys-breast-cancer-rate-has-plummeted-why","authors":["240"],"categories":["stateofhealth_12"],"tags":["stateofhealth_46","stateofhealth_2519","stateofhealth_461"],"featImg":"stateofhealth_90067","label":"stateofhealth"},"stateofhealth_69059":{"type":"posts","id":"stateofhealth_69059","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"69059","score":null,"sort":[1440777879000]},"guestAuthors":[],"slug":"poll-finds-most-women-believe-mammograms-should-be-done-annually","title":"Poll Finds Most Women Believe Mammograms Should Be Done Annually","publishDate":1440777879,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Most women 40 and older believe they should have mammograms every year to screen for breast cancer, the latest NPR-Truven Health Analytics health poll finds.\u003c/p>\n\u003cp>The finding is at odds with \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/breast-cancer-screening\">current recommendations\u003c/a> by the \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Name/about-the-uspstf\">U.S. Preventive Services Task Force\u003c/a> that women with typical risks for breast cancer have screening mammograms every two years starting at age 50 and until they turn 75.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM.png\">\u003cimg class=\"aligncenter wp-image-69113 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM.png\" alt=\"Screen Shot 2015-08-28 at 9.02.03 AM\" width=\"793\" height=\"665\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM.png 793w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM-400x335.png 400w\" sizes=\"(max-width: 793px) 100vw, 793px\">\u003c/a>\u003cbr>\n\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM.png\">\u003cimg class=\"aligncenter wp-image-69115 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM.png\" alt=\"Screen Shot 2015-08-28 at 9.03.26 AM\" width=\"794\" height=\"733\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM.png 794w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM-400x369.png 400w\" sizes=\"(max-width: 794px) 100vw, 794px\">\u003c/a>The decision about mammograms for women in their 40s is a personal one. The task force found a small net benefit for biennial screening of women ages 40 to 49. The guidelines say women should take into account their health situation as well as their views on the benefits of early cancer detection and potential harms, such as unnecessary biopsies and surgery.\u003c/p>\n\u003cp>The USPSTF said there wasn't enough evidence about the benefits from mammograms for women age 75 and up to make a recommendation.\u003c/p>\n\u003cp>The task force is working on an \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/breast-cancer-screening1\">update to the mammography guidelines\u003c/a>, which have sparked controversy since they were last revised in 2009. The \u003ca href=\"http://www.npr.org/sections/health-shots/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\">thrust of the draft advice\u003c/a> is pretty much the same as it has been, but there's more nuanced discussion of the benefits and potential harms for women in their 40s.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The NPR-Truven Health poll found almost two-thirds of women ages 50 to 74 believe that they should have a mammogram annually. For women 40 to 49, the proportion drops to 56 percent. For women under 40, about 45 percent believe they should have a mammogram every year. Overall, 57 percent of women believe an annual mammogram is appropriate.\u003c/p>\n\u003cp>\"The Task Force is happy to see that women are making informed decisions with their doctor about breast cancer screening and continue to have access to mammography screening,\" Dr. Kirsten Bibbins-Domingo, vice chair of the USPSTF, and a professor at UC San Francisco, told Shots in a statement emailed after she reviewed the poll's findings.\u003c/p>\n\u003cp>\"Mammograms are an important tool in helping women avoid deaths from breast cancer. The value of mammography screening increases with age, with women ages 50 to 74 benefitting most from screening. In this age group, the evidence indicates that women get the best balance of benefits to harms when screening is done every 2 years.\"\u003c/p>\n\u003cp>She added, \"The decision to start regular mammography screening for women in their forties should be an individual one that women make in consultation with their doctors and after consideration of their health history, preferences, and how they value the potential benefits and harms of screening.\"\u003c/p>\n\u003cp>The task force's advice is influential, but its guidelines aren't the only ones around. The American Cancer Society, for instance, \u003ca href=\"http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs\">recommends that women 40 and older\u003c/a> \"have a mammogram every year and should continue to do so for as long as they are in good health.\"\u003c/p>\n\u003cp>After reviewing the poll's findings, Dr. Michael Taylor, Truven's chief medical officer, told Shots: \"There needs to be more education about the problem of false positives. If you do mammography every year starting at 40, you're going to find a lot of things that don't matter.\" There may be benefits for some women, but many will also be subjected to unnecessary biopsies and surgeries, he said. \"We don't think enough about the harms of interventions\" triggered by mammography, he said.\u003c/p>\n\u003cp>As for the belief that annual mammograms are best, \u003ca href=\"http://www.uofmhealth.org/profile/320/mark-fendrick-md\">Dr. A. Mark Fendrick\u003c/a>, a professor of internal medicine at the University of Michigan Medical School, says, \"It's much much harder to take away something that you're already doing than it is to start a behavior from time zero.\"\u003c/p>\n\u003cp>\"More isn't always better,\" Fendrick says about screening tests, including mammograms. But there are some people with family histories of disease or who have specific genetic risk factors who should be screened more often, he says.\u003c/p>\n\u003cp>Overall, 48 percent of respondents were aware that the Affordable Care Act \u003ca href=\"https://www.healthcare.gov/preventive-care-benefits/women/\">requires insurers to cover mammograms\u003c/a> without any out-of-pocket costs.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The NPR-Truven Health Analytics Health Poll on mammograms was conducted in June. More than 3,000 women across the country were interviewed. The margin for error is plus or minus 1.8 percentage points. You can find the questions and full results of the latest poll \u003ca href=\"http://truvenhealth.com/Portals/0/NPR-Truven-Health-Poll/NPRPulseMammographyAug2015.pdf\">here\u003c/a>. For previous polls, \u003ca href=\"//www.npr.org/tags/155872782/npr-truven-health-analytics-health-poll/\">click here\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Poll+Finds+Most+Women+Believe+Mammograms+Should+Be+Done+Annually&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"Yet the U.S. Preventive Services Task Force recommendation is for screening mammograms every two years starting at age 50.","status":"publish","parent":0,"modified":1441324658,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":732},"headData":{"title":"Poll Finds Most Women Believe Mammograms Should Be Done Annually | KQED","description":"Yet the U.S. Preventive Services Task Force recommendation is for screening mammograms every two years starting at age 50.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Poll Finds Most Women Believe Mammograms Should Be Done Annually","datePublished":"2015-08-28T16:04:39.000Z","dateModified":"2015-09-03T23:57:38.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"69059 http://ww2.kqed.org/stateofhealth/?p=69059","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/08/28/poll-finds-most-women-believe-mammograms-should-be-done-annually/","disqusTitle":"Poll Finds Most Women Believe Mammograms Should Be Done Annually","nprByline":"Scott Hensley","nprStoryId":"434292252","nprApiLink":"http://api.npr.org/query?id=434292252&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/08/28/434292252/poll-finds-most-women-believe-mammograms-should-be-done-annually?ft=nprml&f=434292252","nprRetrievedStory":"1","nprPubDate":"Fri, 28 Aug 2015 09:50:00 -0400","nprStoryDate":"Fri, 28 Aug 2015 09:40:00 -0400","nprLastModifiedDate":"Fri, 28 Aug 2015 09:50:03 -0400","path":"/stateofhealth/69059/poll-finds-most-women-believe-mammograms-should-be-done-annually","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most women 40 and older believe they should have mammograms every year to screen for breast cancer, the latest NPR-Truven Health Analytics health poll finds.\u003c/p>\n\u003cp>The finding is at odds with \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/breast-cancer-screening\">current recommendations\u003c/a> by the \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Name/about-the-uspstf\">U.S. Preventive Services Task Force\u003c/a> that women with typical risks for breast cancer have screening mammograms every two years starting at age 50 and until they turn 75.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM.png\">\u003cimg class=\"aligncenter wp-image-69113 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM.png\" alt=\"Screen Shot 2015-08-28 at 9.02.03 AM\" width=\"793\" height=\"665\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM.png 793w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM-400x335.png 400w\" sizes=\"(max-width: 793px) 100vw, 793px\">\u003c/a>\u003cbr>\n\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM.png\">\u003cimg class=\"aligncenter wp-image-69115 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM.png\" alt=\"Screen Shot 2015-08-28 at 9.03.26 AM\" width=\"794\" height=\"733\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM.png 794w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM-400x369.png 400w\" sizes=\"(max-width: 794px) 100vw, 794px\">\u003c/a>The decision about mammograms for women in their 40s is a personal one. The task force found a small net benefit for biennial screening of women ages 40 to 49. The guidelines say women should take into account their health situation as well as their views on the benefits of early cancer detection and potential harms, such as unnecessary biopsies and surgery.\u003c/p>\n\u003cp>The USPSTF said there wasn't enough evidence about the benefits from mammograms for women age 75 and up to make a recommendation.\u003c/p>\n\u003cp>The task force is working on an \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/breast-cancer-screening1\">update to the mammography guidelines\u003c/a>, which have sparked controversy since they were last revised in 2009. The \u003ca href=\"http://www.npr.org/sections/health-shots/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\">thrust of the draft advice\u003c/a> is pretty much the same as it has been, but there's more nuanced discussion of the benefits and potential harms for women in their 40s.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The NPR-Truven Health poll found almost two-thirds of women ages 50 to 74 believe that they should have a mammogram annually. For women 40 to 49, the proportion drops to 56 percent. For women under 40, about 45 percent believe they should have a mammogram every year. Overall, 57 percent of women believe an annual mammogram is appropriate.\u003c/p>\n\u003cp>\"The Task Force is happy to see that women are making informed decisions with their doctor about breast cancer screening and continue to have access to mammography screening,\" Dr. Kirsten Bibbins-Domingo, vice chair of the USPSTF, and a professor at UC San Francisco, told Shots in a statement emailed after she reviewed the poll's findings.\u003c/p>\n\u003cp>\"Mammograms are an important tool in helping women avoid deaths from breast cancer. The value of mammography screening increases with age, with women ages 50 to 74 benefitting most from screening. In this age group, the evidence indicates that women get the best balance of benefits to harms when screening is done every 2 years.\"\u003c/p>\n\u003cp>She added, \"The decision to start regular mammography screening for women in their forties should be an individual one that women make in consultation with their doctors and after consideration of their health history, preferences, and how they value the potential benefits and harms of screening.\"\u003c/p>\n\u003cp>The task force's advice is influential, but its guidelines aren't the only ones around. The American Cancer Society, for instance, \u003ca href=\"http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs\">recommends that women 40 and older\u003c/a> \"have a mammogram every year and should continue to do so for as long as they are in good health.\"\u003c/p>\n\u003cp>After reviewing the poll's findings, Dr. Michael Taylor, Truven's chief medical officer, told Shots: \"There needs to be more education about the problem of false positives. If you do mammography every year starting at 40, you're going to find a lot of things that don't matter.\" There may be benefits for some women, but many will also be subjected to unnecessary biopsies and surgeries, he said. \"We don't think enough about the harms of interventions\" triggered by mammography, he said.\u003c/p>\n\u003cp>As for the belief that annual mammograms are best, \u003ca href=\"http://www.uofmhealth.org/profile/320/mark-fendrick-md\">Dr. A. Mark Fendrick\u003c/a>, a professor of internal medicine at the University of Michigan Medical School, says, \"It's much much harder to take away something that you're already doing than it is to start a behavior from time zero.\"\u003c/p>\n\u003cp>\"More isn't always better,\" Fendrick says about screening tests, including mammograms. But there are some people with family histories of disease or who have specific genetic risk factors who should be screened more often, he says.\u003c/p>\n\u003cp>Overall, 48 percent of respondents were aware that the Affordable Care Act \u003ca href=\"https://www.healthcare.gov/preventive-care-benefits/women/\">requires insurers to cover mammograms\u003c/a> without any out-of-pocket costs.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The NPR-Truven Health Analytics Health Poll on mammograms was conducted in June. More than 3,000 women across the country were interviewed. The margin for error is plus or minus 1.8 percentage points. You can find the questions and full results of the latest poll \u003ca href=\"http://truvenhealth.com/Portals/0/NPR-Truven-Health-Poll/NPRPulseMammographyAug2015.pdf\">here\u003c/a>. For previous polls, \u003ca href=\"//www.npr.org/tags/155872782/npr-truven-health-analytics-health-poll/\">click here\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Poll+Finds+Most+Women+Believe+Mammograms+Should+Be+Done+Annually&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/69059/poll-finds-most-women-believe-mammograms-should-be-done-annually","authors":["byline_stateofhealth_69059"],"categories":["stateofhealth_13"],"tags":["stateofhealth_46","stateofhealth_176","stateofhealth_397"],"featImg":"stateofhealth_69060","label":"stateofhealth"},"stateofhealth_58339":{"type":"posts","id":"stateofhealth_58339","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"58339","score":null,"sort":[1438987663000]},"guestAuthors":[],"slug":"is-your-job-increasing-your-risk-of-breast-cancer","title":"Is Your Job Increasing Your Risk of Breast Cancer?","publishDate":1438987663,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>In what they're calling a \"first-of-its-kind\" analysis, the San Francisco-based Breast Cancer Fund has crunched the existing data and released an \u003ca href=\"http://www.breastcancerfund.org/media/publications/reports/working-women-and-breast-cancer.html\" target=\"_blank\">analysis\u003c/a> showing 20 occupations that are associated with elevated risk of breast cancer compared against the general population.\u003c/p>\n\u003cp>The issue is the toxins that people in certain jobs may be exposed to on a daily basis that could increase risk of the disease. Breast Cancer Fund is dedicated to looking specifically at potential \u003ca href=\"http://www.breastcancerfund.org/clear-science/\" target=\"_blank\">environmental factors\u003c/a> that influence development of breast cancer.\u003c/p>\n\u003cp>\"In the course of doing that,\" said Jeanne Rizzo, president and CEO of the group, \"we have come to hear over and over again the issue of occupation exposure. It comes up in scientific literature, that not enough attention is being paid to women in the workplace.\"\u003c/p>\n\u003cp>To examine the available data, Breast Cancer Fund convened 200 experts in a two-year long study group and found increased risk for nurses, teachers, librarians, lawyers, radiology and lab technicians, and journalists.\u003c/p>\n\u003cp>But professional women as a group bear known risk factors for breast cancer, including childbearing at an older age (or not at all), hormone use and alcohol consumption.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Most of the studies in their review already accounted for those risks, Sharima Rasanayagam, director of science at the Breast Cancer Fund, told me.\u003c/p>\n\u003cp>Dr. Robert Hiatt chairs the department of epidemiology and biostatistics at UC San Francisco and has special expertise in breast cancer. He was largely positive about the analysis, saying that it summarized a great deal of studies into one place.\u003c/p>\n\u003cp>But he also noted that breast cancer is a complex disease. \"This report is pretty much focused on chemical exposures, which are one piece of a very complicated picture,\" he said. \"I can't tell how much consideration has been given to the many other factors that are involved.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The authors were clear that more research is needed including:\u003c/p>\n\u003cul>\n\u003cli>Include women in occupational studies\u003c/li>\n\u003cli>Study young women, when possible, and follow their children\u003c/li>\n\u003cli>Measure exposures directly\u003c/li>\n\u003cli>Understand other factors that may affect risk\u003c/li>\n\u003c/ul>\n\n","blocks":[],"excerpt":"The question is the toxic chemicals working women may be exposed to every day.","status":"publish","parent":0,"modified":1439011390,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":11,"wordCount":347},"headData":{"title":"Is Your Job Increasing Your Risk of Breast Cancer? | KQED","description":"The question is the toxic chemicals working women may be exposed to every day.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Is Your Job Increasing Your Risk of Breast Cancer?","datePublished":"2015-08-07T22:47:43.000Z","dateModified":"2015-08-08T05:23:10.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"58339 http://ww2.kqed.org/stateofhealth/?p=58339","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/08/07/is-your-job-increasing-your-risk-of-breast-cancer/","disqusTitle":"Is Your Job Increasing Your Risk of Breast Cancer?","path":"/stateofhealth/58339/is-your-job-increasing-your-risk-of-breast-cancer","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In what they're calling a \"first-of-its-kind\" analysis, the San Francisco-based Breast Cancer Fund has crunched the existing data and released an \u003ca href=\"http://www.breastcancerfund.org/media/publications/reports/working-women-and-breast-cancer.html\" target=\"_blank\">analysis\u003c/a> showing 20 occupations that are associated with elevated risk of breast cancer compared against the general population.\u003c/p>\n\u003cp>The issue is the toxins that people in certain jobs may be exposed to on a daily basis that could increase risk of the disease. Breast Cancer Fund is dedicated to looking specifically at potential \u003ca href=\"http://www.breastcancerfund.org/clear-science/\" target=\"_blank\">environmental factors\u003c/a> that influence development of breast cancer.\u003c/p>\n\u003cp>\"In the course of doing that,\" said Jeanne Rizzo, president and CEO of the group, \"we have come to hear over and over again the issue of occupation exposure. It comes up in scientific literature, that not enough attention is being paid to women in the workplace.\"\u003c/p>\n\u003cp>To examine the available data, Breast Cancer Fund convened 200 experts in a two-year long study group and found increased risk for nurses, teachers, librarians, lawyers, radiology and lab technicians, and journalists.\u003c/p>\n\u003cp>But professional women as a group bear known risk factors for breast cancer, including childbearing at an older age (or not at all), hormone use and alcohol consumption.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Most of the studies in their review already accounted for those risks, Sharima Rasanayagam, director of science at the Breast Cancer Fund, told me.\u003c/p>\n\u003cp>Dr. Robert Hiatt chairs the department of epidemiology and biostatistics at UC San Francisco and has special expertise in breast cancer. He was largely positive about the analysis, saying that it summarized a great deal of studies into one place.\u003c/p>\n\u003cp>But he also noted that breast cancer is a complex disease. \"This report is pretty much focused on chemical exposures, which are one piece of a very complicated picture,\" he said. \"I can't tell how much consideration has been given to the many other factors that are involved.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The authors were clear that more research is needed including:\u003c/p>\n\u003cul>\n\u003cli>Include women in occupational studies\u003c/li>\n\u003cli>Study young women, when possible, and follow their children\u003c/li>\n\u003cli>Measure exposures directly\u003c/li>\n\u003cli>Understand other factors that may affect risk\u003c/li>\n\u003c/ul>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/58339/is-your-job-increasing-your-risk-of-breast-cancer","authors":["240"],"categories":["stateofhealth_11"],"tags":["stateofhealth_46"],"featImg":"stateofhealth_58386","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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